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One is bad enough.
For the small percentage of people who suffer both a heart attack and a stroke, treatment and recovery for the potentially life-threatening conditions can seem twice as tough.
Some medications for treating the conditions don't always mix. And heart surgery might require scaling back physical therapy for the stroke.
“It becomes overwhelming for the family and the patient,'' said Dr. Pierre Fayad, director of the Stroke Center at the Nebraska Medical Center. “You are talking with them about the stroke and all the problems that come with it. Then you have to speak to them about the heart attack.”
Those are the challenges possibly facing Chuck Sigerson, 64, an Omaha city councilman who experienced a heart attack and a stroke on Saturday.
A heart attack occurs when blood flow to the heart is blocked. The most common type of stroke occurs when blood flow to the brain is blocked.
The two conditions share such risk factors as high blood pressure, high cholesterol and smoking.
What occurred to Sigerson is not common.
About 1 percent of those admitted to the hospital with numbness and other stroke symptoms might suffer a heart attack within a week, Fayad said. Of patients admitted with chest pains and other heart attack symptoms, about 10 percent might suffer a stroke within that same period.
It's not well-understood why some patients suffer both because it's so uncommon, said Dr. Jeff Carstens, executive medical director of the Heart and Vascular Institute for Alegent Health.
Heart attacks can create blood clots in the heart, which can break loose and travel to the brain, possibly causing a stroke, Fayad said. He is also chairman of neurological sciences at the University of Nebraska Medical Center.
The more severe the heart attack, the more likely clots will form in the heart, said Dr. Syed Mohiuddin, chairman of the department of medicine at the Creighton University School of Medicine.
Recovery can be tough. A drug commonly used for heart attacks could cause bleeding in the area of the brain where the stroke occurred, Fayad said.
Sometimes heart surgery must be postponed until brain injuries caused by the stroke have stabilized. Drugs used in the surgery could aggravate those injuries.
For many stroke victims, physical and speech therapy is essential. But sometimes the intensity of the therapy must be scaled back for weeks or months while the patient recovers from heart surgery.
Two years ago, Richard Almgren of Omaha suffered a heart attack and several days later suffered a stroke, said Fayad, who treated him.
He has fully recovered from the heart attack, but short-term memory problems persist because of the stroke said Donna Almgren, his wife.
Her husband, 62, returned to work after two months. He was out because of a heart procedure and physical and speech therapy.
He is co-owner of Pruitt Outdoor Power, an engine repair and lawn mower and snow blower sales company. Before his medical problems he handled sales, providing price quotes and other details to customers.
Because of the stroke, he has trouble retrieving words, a sign of memory problems. So now he focuses mostly on engine repair.
Even though his recovery has been hard, his family is thankful. He can walk, golf and bowl, activities that would be tough for some stroke victims.
“It could have been a lot worse,'' his wife said.
Contact the writer:
444-1122, michael.oconnor@owh.com
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